Course name | Date

Amalric Triangular Choroidal Infarction in Giant Cell Arteritis

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD
Presenter/Faculty: Patel
The patient presented with ocular ischemic syndrome and corneal edema in the fellow eye. In the right eye on angiography there is temporal non-perfusion as well as choroidal hyperfluorescent infarcts in the late phases. ESR and CRP were elevated. Diagnosis of GCA was made. The patient retained 20/3…

Anterior Chamber Intra-Ocular Lens

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Harry W. Flynn, Jr., MD; Nimesh A. Patel, MD
Presenter/Faculty: Flynn, Patel

A well-positioned ACIOL with superior nasal iridotomy.

Bartonella Neuroretinitis

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Norman Schatz, MD
Presenter/Faculty: Patel, Schatz

Fundus photo with exudates in a stellate pattern surrounding macula. OCT showing the hyperdense exudates in the outerplexiform layer.

Bee Stinger in the Cornea

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Sonia H. Yoo, MD
Presenter/Faculty: Patel, Yoo

The bee stinger seen in the cornea has remained stable for many years and not affected the vision or required removal.

Bilateral Retinal Artery Occlusions

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Janet L. Davis, MD; Nimesh A. Patel, MD; Brandon Sparling
Presenter/Faculty: Davis, Patel, Sparling

Right eye with central retinal artery occlusion and left eye with superior branch retinal artery occlusion.

Birdshot Chorioretinopathy

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Janet L. Davis, MD; Nimesh A. Patel, MD
Presenter/Faculty: Davis, Patel
Fundus photos with creamy yellow sub-retinal lesions emanating radially from the nerve. FA OS with late staining and ICG with delineated hypocyanescent spots in the mid and late phases. The patient was HLA-A29 positive. ERG was used to monitor, assessing the B wave for a delayed 30hz flicker time.

Carotid Cavernous Fistula with Ocular Ischemic Syndrome

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Andrew J. Rong, MD
Presenter/Faculty: Patel, Rong
Slit lamp photo with dilated epi-scleral veins. Fundus photo with retinal hemorrhages. FA with severe non perfusion, leakage from the disc, and laser scars. MRI/MRA demonstrates left distal precavernous/proximal cavernous ICA fistula into the cavernous sinus with arterialized flow. There is resulta…

Central Retinal Vein Occlusion Associated with Cocaine Abuse

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Jonathan F. Russell, MD, PhD; Jesse D. Sengillo, MD
Presenter/Faculty: Patel, Russell, Sengillo

A 40-year-old patient with systemic hypertension and history of polysubstance abuse. CBC was within normal limits. Photo shows dilated and engorged vessels, cotton wool spots, and flame hemorrhages.

Central Serous Retinal with Choroidal Neovascularization

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD
Presenter/Faculty: Patel

Fundus photos showing sub-retinal angiogenesis with hemorrhage. OCT with pigment epithelial detachment and outer-retinal atrophy. Autofluorescence with a guttering pattern of the atrophy typical with CSR.

Choroidal Osteoma

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Harry W. Flynn, Jr., MD; Nimesh A. Patel, MD; Swarup S. Swaminathan, MD
Presenter/Faculty: Flynn, Patel, Swaminathan

Fundus photo with hypopigmented patch with choroidal thickening temporally. B-scan demonstrates the fundus thickening with mild hyperdensity.

Christmas Tree Cataract in Myotonic Dystrophy

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Swarup S. Swaminathan, MD
Presenter/Faculty: Patel, Swaminathan

The multicolored appearance is due to needle shaped polychromatic peptide crystals in the cortex or nucleus of the lens. These are not generally visually significant.

Chronic Macula Changes with Juvenile X-linked Retinoschisis

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Harry W. Flynn, Jr., MD; Nimesh A. Patel, MD
Presenter/Faculty: Flynn, Patel

This patient is known to have XLRS and is 80 years old. Over time the macula schisis has led to central atrophy and pigmentary changes. The OCT shows schisis cavities and thinning of the retina.

Chronic Macula on Retinal Detachment with Two Demarcation Lines

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): J. Daniel Diaz, MD; Nimesh A. Patel, MD; Justin H. Townsend, MD
Presenter/Faculty: Diaz, Patel, Townsend

Patient with a history of pathological myopia and retinal detachment in the fellow eye. Has been stable with a large chronic retinal detachment. There are two demarcation lines noted in the macula. The vision is preserved.

Chronic Retinal Detachment with Laser Demarcation

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Harry W. Flynn, Jr., MD
Presenter/Faculty: Patel, Flynn

Temporal horseshoe tear with localized retinal detachment. It was demarcated with laser retinopexy and has remained stable.

Ciliary Body Metastatic Lung Tumor

Specialty: Ocular Oncology
Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): J. William Harbour, MD; Nimesh A. Patel, MD
Presenter/Faculty: Harbour, Patel

Slit lamp photo with white tumor growing into the sulcus inferior temporally. The Ultrasound Biomicroscopy shows a medium density mass in the ciliary body. The patient had known stage 4 lung cancer.

Coats' Disease Stage 4

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Victor Villegas, MD
Presenter/Faculty: Patel, Villegas

RetCam photo with a bullous exudative retinal detachment. Angiography shows area of engorged vessels, telangiectasias and neovascularization. Ultrasound with moderate dense vitreous opacities and no calcifications. Surgery with external drainage was required for treatment.

Conjunctival Melanoma

Specialty: Ocular Oncology
Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Carol L. Karp, MD; Nimesh A. Patel, MD; Swarup S. Swaminathan, MD
Presenter/Faculty: Karp, Patel, Swaminathan

A large pigmented nasal growth with vascularization. This case was treated with surgery using a 'no touch technique' excisional biopsy with 4 mm margins and amniotic membrane tissue placement.

Cytomegalovirus Retinitis with Frosted Branch Angiitis

Specialty: Uveitis
Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Thomas A. Albini, MD; Nimesh A. Patel, MD
Presenter/Faculty: Albini, Patel

Immunocompromised patient with HIV and CMV retinitis. The perivascular inflammation and whitening are known as frosted branch angiitis.

Didanosine Toxicity

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Nimesh A. Patel, MD; Justin H. Townsend, MD
Presenter/Faculty: Patel, Townsend

Patient with HIV on treatment with Didanosine. Fundus photos with peripheral, well circumscribed, patchy choroidal atrophy in both eyes.

Diffuse Unilateral Subacute Neuroretinitis (DUSN) Treated With Laser

Type: Ophthalmic Images
Include in Catalogue?: Yes
Original Contributor(s): Audina M. Berrocal, MD; Nimesh A. Patel, MD
Presenter/Faculty: Berrocal, Patel

Fundus photo with multifocal unilateral white dots and central atrophy. On closer inspection a sub retinal nematode is found. Post laser treatment with laser photocoagulation and with many years of follow up there was no progression of the uveitis.